Claim total
$15,484.76
base $93.39 · payer covered $15,484.76
The visit
- Class
- Ambulatory
- Code
- 270427003
- Reason
- diagnosis concept Normal pregnancy72892002
- Start
- 2024-07-29
- Stop
- 2024-07-29
The parties
- Patient
- patient Cristina Caridad Salcedo
- Provider
- provider Jack Boehm
- Care site
- care site ALLINA HEALTH SYSTEM
- Payer
- payer Humana
Record id
031e24ca-9978-b353-0fa4-e9af419499ae